{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T08:17:27Z","timestamp":1770279447286,"version":"3.49.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study investigates our enhanced recovery after minimally invasive cardiac surgery program \u201cenhanced recovery after minimally invasive cardiac surgery\u201d (ERMICS) following a \u2018Zero ICU\u2019 concept compared to standard-of-care treatment in terms of safety and clinical efficacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All patients who underwent minimally invasive mitral valve surgery for primary severe mitral valve regurgitation between 2021 and 2023 were included. Propensity score matching (2:1) was performed between patients who received standard-of-care treatment and those who underwent ERMICS. Patients treated with the ERMICS approach were transferred to the peripheral ward instead of the intensive care unit on the day of surgery (Zero ICU). Separate primary end-points were safety (mortality, stroke), postoperative ventilation time and hospital length of stay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 611 patients (566 standard of care vs 45 ERMICS) were included in the study. After 2:1 matching, the cohort comprised 135 patients (90 standard of care vs 45 ERMICS) and were well balanced in terms of pre- and intraoperative variables. Thirty-day mortality was 0% in both groups. Postoperative ventilation time [P\u2009=\u20090.018, odds ratio (OR)\u2009&amp;lt;\u20090.01, confidence interval (CI) &amp;lt; 0.001], postoperative pain (P\u2009=\u20090.005, OR\u2009=\u20090.36, CI 0.18\u20130.74) and hospital length of stay (P\u2009=\u20090.049, OR\u2009=\u20090.28, CI 0.08\u20130.98) was significantly lower in ERMICS patients, while postoperative complications did not differ.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our ERMICS \u2018Zero ICU\u2019 concept is safe and leads to significantly shorter postoperative ventilation time and hospital length of stay for patients undergoing minimally invasive mitral valve surgery for primary severe mitral valve regurgitation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezae439","type":"journal-article","created":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T12:13:53Z","timestamp":1734178433000},"source":"Crossref","is-referenced-by-count":8,"title":["Enhanced recovery after minimally invasive cardiac surgery following a zero ICU concept\u2014a propensity score-matched analysis"],"prefix":"10.1093","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0339-5791","authenticated-orcid":false,"given":"Leonard","family":"Pitts","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Dini","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7843-1022","authenticated-orcid":false,"given":"Simon","family":"Goecke","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Kofler","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sascha","family":"Ott","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2028-2039","authenticated-orcid":false,"given":"Christian","family":"Stoppe","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7024-2337","authenticated-orcid":false,"given":"Benjamin","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site , Berlin,","place":["Germany"]},{"name":"Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-8620","authenticated-orcid":false,"given":"Volkmar","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site , Berlin,","place":["Germany"]},{"name":"Translational Cardiovascular Technologies, Institute of Translational Medicine, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH) , Zurich,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Hommel","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-6375","authenticated-orcid":false,"given":"J\u00f6rg","family":"Kempfert","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site , Berlin,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"key":"2024121419364669900_ezae439-B1","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1053\/j.jvca.2021.02.035","article-title":"Optimal management of patients treated with minimally invasive cardiac surgery in the era of enhanced recovery after surgery and fast-track protocols: a narrative review","volume":"36","author":"Maj","year":"2022","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2024121419364669900_ezae439-B2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac451","article-title":"Factors associated with an unsuccessful fast-track course following minimally invasive surgical mitral valve repair","volume":"62","author":"Van Praet","year":"2022","journal-title":"Eur J Cardio-Thorac Surg"},{"key":"2024121419364669900_ezae439-B3","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1001\/jamasurg.2019.1153","article-title":"Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations","volume":"154","author":"Engelman","year":"2019","journal-title":"JAMA Surg"},{"key":"2024121419364669900_ezae439-B4","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.ijcard.2022.11.016","article-title":"Enhanced recovery after minimally invasive heart valve surgery: early and midterm outcomes","volume":"370","author":"Berretta","year":"2023","journal-title":"Int J Cardiol"},{"key":"2024121419364669900_ezae439-B5","doi-asserted-by":"crossref","first-page":"e0231378","DOI":"10.1371\/journal.pone.0231378","article-title":"Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery","volume":"15","author":"Kubitz","year":"2020","journal-title":"PLoS One"},{"key":"2024121419364669900_ezae439-B6","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.athoracsur.2023.12.006","article-title":"Perioperative care in cardiac surgery: a joint consensus statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and The Society of Thoracic Surgeons (STS)","volume":"117","author":"Grant","year":"2024","journal-title":"Ann Thorac Surg"},{"key":"2024121419364669900_ezae439-B7","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease: developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur Heart J"},{"key":"2024121419364669900_ezae439-B8","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1186\/s12913-021-06218-5","article-title":"Economic impact of enhanced recovery after surgery protocol in minimally invasive cardiac surgery","volume":"21","author":"Petersen","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"2024121419364669900_ezae439-B9","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.jtcvs.2023.08.019","article-title":"Enhanced recovery after surgery program for patients undergoing isolated elective coronary artery bypass surgery improves postoperative outcomes","volume":"168","author":"Schneider","year":"2024","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024121419364669900_ezae439-B10","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.ccc.2020.07.001","article-title":"How to start an enhanced recovery after surgery cardiac program","volume":"36","author":"Jawitz","year":"2020","journal-title":"Crit Care Clin"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/66\/6\/ezae439\/61167021\/ezae439.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/66\/6\/ezae439\/61167021\/ezae439.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T19:36:56Z","timestamp":1734205016000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezae439\/7914932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,28]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,11,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezae439","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,12]]},"published":{"date-parts":[[2024,11,28]]},"article-number":"ezae439"}}